This is part 2 of a 2 part series: Part 1

Are you facing a situation in your church that will require pastoral care over a long period of time? If you don’t have a situation like that now – you will in the future. Are you ready for it?

In part 1 of this article, Tim Lane recommended that churches respond to long term pastoral care needs by forming a small group to provide and supervise care. Here in part 2 he continues to describe how that care group should function and suggests a couple books on the subject that you might find helpful.

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Be Attentive to Phases of Care

  • Deer in Headlights Phase — the family needs someone to help them think clearly. Sometimes people need to be reminded to eat! This is the place where people step in and remind the family that not all is caving in and that they are surrounded by a loving community of believers who will shoulder the burden together with them. This is the beginning of the crisis. If you have any idea that it is long term, mobilize a care group.
  • This Isn’t Going Away Phase — the family and those involved get a clear picture early on that this is going to be something that will not be resolved quickly and that long term care will be needed. At this point you need to ramp up care to handle the indefinite time frame. This is where the small group needs to be involved. One thing that is important to communicate to the family is that you will be there for the long-haul. You need to mean that. There are people in your congregation who are at stages and seasons of life that can be more available (singles and empty nesters). This is a wonderful place for them to serve.
  • Settling In Phase — the small group and helpers are in a groove. The family is out of crisis mode and beginning to return to a more normal routine. Although life has been radically disrupted, the family has adjusted and is beginning to take more responsibility for their own day to day needs. This is when the small group overseeing things will need to re-evaluate what the ongoing needs are, how they will be handled, and how to guard everyone from burn-out.
  • This Is the Way It Is Phase — at this point, the small group needs to decide what the family’s ongoing needs will be and what the family can begin to do for themselves. It is also crucial to attend to the needs of those who have been caring for the family. This, to me, is where the elder and deacon in the group need to focus. They are there to care for the care-givers. This protects both officers and care-givers from burning out.

Be Aware of Financial and Legal Needs

Insurance covers less and less medical care and very little in the way of counseling. In most churches, mission committees have large budgets. Why not increase the size of the Mercy/Care budget to prepare for these types of crises. Also, there are ways to set up funds for families to help off-set costs. Develop a filing system to help the family keep up with the bills. Bring in a financial planner if it is going to be long term. Seek the advice of a lawyer if needed. It is important to always do this with the family’s permission. If possible, have one person from the small group present at these meetings.

Combine Word and Deed

This is a form of care that early on will be largely deed oriented, but the longer it goes the more the Word component of care will become important. In general, unless you are going to equip your care givers to speak wisely, it is best to encourage them to err on the side of listening, but in the long term that is not sufficient. In the midst of long term suffering there is a cry for understanding. It is here that we need to equip our people to give wise, time sensitive, biblical, Christ-centered counsel as people ask the difficult questions. Helpers can never go wrong by focusing on the Psalms. This may be an opportunity to teach and equip your church. Again, have a trained person assist you in providing good information along with a biblical perspective to help the care-givers think and act and speak in sensitive ways in light of the specific crisis issue. For example, when someone has a terminal illness, it is inappropriate to tell them they will make it in an effort to be upbeat and positive. One of the reasons is that you don’t know God’s sovereign will for the person and it will also possibly give the impression that the person is not trying if they get worse.

Don’t Understimate the Importance of Scripture

The Scriptures give a person and family words to express themselves in godly ways and it constantly pulls them out of the temptation to just dive inward and become cynical. The following psalms might prove helpful: Psalm 4, 18, 23, 27, 40, 42, 121, 130, and 142.

Focus on Everyone Involved

When responding to a crisis and looking long term, it is important to focus on the whole family not just the individual who is at the center of the crisis; the spouse and children, if it is a family. What kind of care and encouragement are they receiving? The suffering of the person at the center is also bringing suffering into the lives of those around the person. Heart issues and pastoral care will be needed for them as well. Think of creative ways to encourage and support those around the person who is at the center.

Pay Attention to Little Details

Get a list of foods that the family can and cannot eat so when meals are brought – they are suitable. Child care: depending on the age—homework, school activities, things that continue. Transportation; Hospital contact: have someone do this for the family daily. Listen to doctors with the family to help them hear. Don’t forget to pray with the family regularly. Keep elders/deacons/pastors informed. Housework. Yard work. Groceries, errands, paying basic bills, etc. daily life stuff! In situations like this, mistakes are inevitable. Learn and adjust along the way.

Don’t Bypass the Heart Issues of the Care Givers

This is a form of suffering that will reveal the heart. Not just the heart of the sufferer but the care-givers of the sufferer. The call to love that perseveres shows our true colors! Be attentive to what is getting revealed and be prepared to remind people of the gospel. Activists who burn out need to be reminded that they are not establishing a record of righteousness or burning karma by doing service. Others jump in and back out when they are afraid of getting too immersed. They need to be helped to see that love is persevering and that they can grow in and through this. 1 Peter reminds us of how God is working in the now to refine and help us grow. This is true of everyone who is involved. It has been amazing to me to see the maturity produced in individuals and churches that have gone through intense, long term care like this. It has also caused sin to boil to the surface. Several years after all the care has been provided, there may be a need to redress wrongs and help people pursue reconciliation. One thing is certain; you and your church will not remain the same.


No church is perfect but a prepared church will respond better when these difficult problems come. Though many will volunteer to help out in an immediate crisis, it is the long term needs that strain the resources of the church and reveal its weaknesses. To keep love constant is a challenge but Christ calls us to meet the challenge with his help.

Helpful Resources

Here are three books you might find helpful as you think about these issues:

  • The Crisis of Caring: Recovering the Meaning of True Fellowship, Jerry Bridges, P&R, 1992. This book does a nice job of grounding our fellowship with one another in our union with Christ. It can be a useful book to help your congregation begin to move in the direction of practical ministry to others that may include long term care.
  • The Hidden Smile of God, John Piper, Crossway Books, 2008. This book looks at three individuals from the standpoint of suffering and the grace of God: John Bunyan, William Cowper, and David Brainerd. It can be a useful look into suffering from a very personal perspective.


This is part two of a two part series: Part 1